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dc.contributor.author
Dip, Fernando
dc.contributor.author
Falco, Jorge
dc.contributor.author
Verna, Silvina
dc.contributor.author
Prunello, Marcos Miguel
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dc.contributor.author
Loccisano, Matias
dc.contributor.author
Quadri, Pablo
dc.contributor.author
White, Kevin
dc.contributor.author
Rosenthal, Raul
dc.date.available
2020-07-16T17:22:04Z
dc.date.issued
2019-01
dc.identifier.citation
Dip, Fernando; Falco, Jorge; Verna, Silvina; Prunello, Marcos Miguel; Loccisano, Matias; et al.; A Randomized, Controlled Trial Comparing White-Light with Near-Infrared Autofluorescence for Parathyroid Gland Identification during Total Thyroidectomy; Elsevier Science Inc; Journal Of The American College Of Surgeons; 228; 5; 1-2019; 744-751
dc.identifier.issn
1072-7515
dc.identifier.uri
http://hdl.handle.net/11336/109424
dc.description.abstract
Background: Parathyroid glands are difficult to identify during total thyroidectomies and accidental resection can lead to problematic post-operative hypocalcemia. Our main goals were to evaluate the effectiveness of using near-infrared light (NIRL) auto-fluorescence intra-operatively for parathyroid-gland identification; and to measure its impact on postoperative hypocalcemia incidence.Study Design
Total thyroidectomies were performed on 170 patients with different thyroid pathologies, block-randomized (1:1) into 2 equal groups. Among controls, traditional overhead white light (WL) was used throughout. In the experimental group, NIRL was used to enhance parathyroid gland recognition before thyroid dissection. The number of parathyroid glands identified was compared after thyroid dissection in controls using WL vs pre-dissection in the experimental using NIRL and with WL vs NIRL before thyroid dissection in the experimental group. Postoperative serum calcium levels and hypocalcemia rates were compared. Results: The mean number of parathyroid glands identified pre-dissection with NIRL was the same identified post-dissection with WL (3.5 vs 3.6). In the experimental group, converting from WL to NIRL increased the number of glands detected from 2.6 to 3.5 (p < 0.001), and revealed at least 1 previously missed gland in 67.1% of patients. Calcium levels ≤7.5 mg/dL were one-tenth as common in the NIRL group (p = 0.005). The adjusted odds of hypocalcemia developing increased by 15% for every 5-g increase in thyroid gland weight (odds ratio 1.15; 95% CI 1.06 to 1.25). All hypocalcemia resolved within 6 months. Conclusions: Using NIRL during thyroidectomy increases intraoperative identification of parathyroid glands, enhances their detection before thyroid dissection, and decreases the incidence of postoperative hypocalcemia.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Elsevier Science Inc
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dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
HYPOCALCEMIA
dc.subject
IMAGING
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NEAR-INFRARED LIGHT
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PARATHYROID
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THYROIDECTOMY
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Otras Ciencias de la Salud
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dc.subject.classification
Ciencias de la Salud
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dc.subject.classification
CIENCIAS MÉDICAS Y DE LA SALUD
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dc.title
A Randomized, Controlled Trial Comparing White-Light with Near-Infrared Autofluorescence for Parathyroid Gland Identification during Total Thyroidectomy
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2020-07-01T20:39:12Z
dc.journal.volume
228
dc.journal.number
5
dc.journal.pagination
744-751
dc.journal.pais
Estados Unidos
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dc.journal.ciudad
New York
dc.description.fil
Fil: Dip, Fernando. instituto Argentino de Diagnóstico y Tratamiento; Argentina
dc.description.fil
Fil: Falco, Jorge. Instituto Argentino de Diagnóstico y Tratamiento; Argentina
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Fil: Verna, Silvina. Instituto Argentino de Diagnóstico y Tratamiento; Argentina
dc.description.fil
Fil: Prunello, Marcos Miguel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Facultad de Cs.bioquimicas y Farmaceuticas. Departamento de Matematica y Estadistica.; Argentina
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Fil: Loccisano, Matias. Instituto Argentino de Diagnóstico y Tratamiento; Argentina
dc.description.fil
Fil: Quadri, Pablo. Instituto Argentino de Diagnóstico y Tratamiento; Argentina
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Fil: White, Kevin. Scienceright Research Consultations; Canadá
dc.description.fil
Fil: Rosenthal, Raul. Cleveland Clinic Florida; Estados Unidos
dc.journal.title
Journal Of The American College Of Surgeons
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dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://linkinghub.elsevier.com/retrieve/pii/S107275151930081X
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1016/j.jamcollsurg.2018.12.044
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